title: Does hysteroscopy improve upon the sensitivity of dilatation and curettage in the diagnosis of endometrial hyperplasia or carcinoma?
abstract: OBJECTIVE
  The objective of this study was to determine whether hysteroscopy improved upon the diagnostic sensitivity of dilatation and curettage (D+C) in the detection of endometrial hyperplasia and carcinoma.
  
  
  METHODS
  A retrospective chart review was conducted of all patients undergoing hysteroscopy/D+C for abnormal uterine bleeding between 1991 and 1995. Hysteroscopic impressions and D+C diagnoses were compared.
  
  
  RESULTS
  Three hundred seventy-three patients were included in the study. Of the 61 patients with D+C demonstrating hyperplasia, the hysteroscopic impression was hyperplasia in 32 (52%). Of the 10 patients with D+C demonstrating carcinoma, the hysteroscopic impression was hyperplasia in 8 (80%) and carcinoma in 2 (20%). Two additional cases of carcinoma were diagnosed within 6 months of hysteroscopy/D+C, and both had been missed on both hysteroscopy and D+C. Of 204 patients with a normal hysteroscopic impression, 23 (11%) had hyperplasia on D+C.
  
  
  CONCLUSIONS
  Hysteroscopy did not improve upon the sensitivity of D+C in the detection of endometrial hyperplasia or carcinoma.
authors.affiliation: Department of Obstetrics and Gynecology, Cedars-Sinai Medical Center, Los Angeles, California, USA.
authors.forename: O M
authors.initials: OM
authors.lastname: Ben-Yehuda
authors.forename: Y B
authors.initials: YB
authors.lastname: Kim
authors.forename: R S
authors.initials: RS
authors.lastname: Leuchter
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004107:Dilatation and Curettage / Q000009:adverse effects / Q000379:methods / Q000592:standards*; D004714:Endometrial Hyperplasia / Q000175:diagnosis* / Q000453:epidemiology / Q000473:pathology; D016889:Endometrial Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000473:pathology; D004717:Endometrium / Q000473:pathology; D005260:Female; D006801:Humans; D015907:Hysteroscopy / Q000009:adverse effects / Q000379:methods / Q000592:standards*; D015994:Incidence; D008875:Middle Aged; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014595:Uterine Perforation / Q000453:epidemiology / Q000209:etiology